Elders' nonadherence: its assessment and medication reminding by voice mail.

This study investigates four questions related to the problem of medication nonadherence among elders. First, does memory failure play a significant role in nonadherence? Second, can memory-related nonadherence be predicted by simple tests of cognitive performance? Third, can the new portable bar code scanner technology be used to unobtrusively monitor nonadherence? Most importantly, can inexpensive telephone voice mail technology be used to improve medication adherence? The results show that: elders have substantial levels of forgetting; nonadherence decreases with higher cognitive test scores; portable bar code scanners are useful for monitoring adherence; and voice mail reduces tardiness and complete forgetting.

Memory skills elders want to improve.

While many research studies have investigated memory training for elders, none have asked which specific memory skills elders would like to improve. This study investigates two related questions. First, which memory skills elders would like to improve? Second, is there a common set of these memory skills? Elders completed a three-part questionnaire. First, it asked for subject demographics. Second, it asked for the first, second, third, and then all other memory skills they would most like to improve. Finally, it asked elders to rate the importance of 10 specific memory skills. The results indicate that elders share a common set of memory skills they wish to improve. They are: (a) people's names, (b) important dates, (c) location of household objects, (d) recent and past events, (e) meetings and appointments, (f) information and facts, (g) general improvement, and (h) medication. One conclusion from these findings is that at least some memory training research should focus on these specific memory skills.

Increasing influenza vaccination adherence through voice mail.

The number of influenza and influenza-related deaths is alarmingly high, yet mean vaccination adherence rates among the high-risk elderly population remain at only 20%. The present study investigates the use of an inexpensive voice-mail system, TeleMinder, as a method of increasing influenza vaccination adherence among a subpopulation of elders identified as low adherers. The first group of older people received no intervention. Group 2 received a voice-mail message informing them of the cost, time, date, and location of an influenza vaccination clinic. Group 3 was exposed to posted and verbal announcements alone. Group 4 both received voice mail and was exposed to posted and verbal announcements. Vaccination adherence levels for groups 1 through 4 were 1.5%, 11.8%, 7.4%, and 37.5%, respectively. Voice mail significantly increased vaccination adherence either alone or in combination with posted and verbal announcements. These findings suggest that voice mail provides an inexpensive means of increasing influenza vaccination rates.

Elders' nonadherence, its assessment, and computer assisted instruction for medication recall training.

This study investigates three questions related to the problem of medication nonadherence among elders. First, does recall failure play a significant role in nonadherence? Recent research suggests that it may not. Second, can the new portable bar code scanner technology be used to study nonadherence? Other forms of monitoring are obtrusive or inaccurate. Finally, can inexpensive computer assisted instructions (CAI) be used to teach mnemonic techniques specifically designed to improve medication schedule recall? Current research on memory training teaches nonspecific mnemonics and uses the expensive classroom approach. Results of the present study suggest that physically active and cognitively alert elders do have significant nonadherence (control group = 32.0%) problems related to forgetting and that CAI courseware can significantly reduce (medication recall training group = 10.0%) this form of nonadherence. Portable bar code technology proved easy to use by elderly patients and provided detailed information about the type of forgetting underlying nonadherence. Most significant recall failure was in the complete forgetting to take medication rather than delays in medicating or overmedicating.